New oral anticoagulants and neuraxial regional anesthesia

Abstract

Purpose of review: As the increased use of new oral anticoagulants may put patients at particular risk of bleeding, experts suggested strategies to perform neuraxial anesthesia as well tolerated as possible. This review summarizes different approaches.

Recent findings: Data from licensing studies, drug pharmacology, registries, authorities and expert opinions are available and covered by the article. Spinal epidural hematoma formation associated with neuraxial blocks is rare. There has been no epidural hematoma described in the scientific literature with the concurrent use of new oral anticoagulants and neuroaxial anesthesia yet.

Summary: A simplified approach covering recent recommendations is given which may aid well tolerated use of neuraxial blocks in patients taking new oral anticoagulants.